Thursday, June 30, 2005

Doctors Complicit in Torture

No military can torture without doctors. JAMA published an editorial to this effect last year. Dr Lifton writes:

To be a military physician is to be subject to potential moral conflict between commitment to the healing of individual people, on the one hand, and responsibility to the military hierarchy and the command structure, on the other. I experienced that conflict myself as an Air Force psychiatrist assigned to Japan and Korea some decades ago: I was required to decide whether to send psychologically disturbed men back to the United States, where they could best receive treatment, or to return them to their units, where they could best serve combat needs. There were, of course, other factors, such as a soldier's pride in not letting his buddies down, but for physicians this basic conflict remained.

American doctors at Abu Ghraib and elsewhere have undoubtedly been aware of their medical responsibility to document injuries and raise questions about their possible source in abuse. But those doctors and other medical personnel were part of a command structure that permitted, encouraged, and sometimes orchestrated torture to a degree that it became the norm — with which they were expected to comply — in the immediate prison environment.

The doctors thus brought a medical component to what I call an "atrocity-producing situation" — one so structured, psychologically and militarily, that ordinary people can readily engage in atrocities. Even without directly participating in the abuse, doctors may have become socialized to an environment of torture and by virtue of their medical authority helped sustain it. In studying various forms of medical abuse, I have found that the participation of doctors can confer an aura of legitimacy and can even create an illusion of therapy and healing.

It has been reported that the New England Journal will release a report this month that the US military physicians in Guantanamo Bay and Iraqi detention facilities have been breaking confidentiality to aid interrogators.

Physicians have sworn that "even under threat, I will not use my medical knowledge contrary to the laws of humanity" [Hippocratic oath formulated at Geneva]. The skills physicians learn and the trust they are given are easily perverted to the service of the state. I hope that the lessons of the past weigh on the consciences of any doctors involved in unsavory treatment of foreign combatants in US custody, and that they eventually come forward with what they know.